Central Serous Chorioretinopathy

Central Serous Chorioretinopathy (CSCR) is a visual impairment, often temporary, that usually occurs in only one eye. The disorder is characterized by leakage of fluid in center of the retina. This leakage leads to a serous detachment, or blister, beneath the retina which may result in blurred or distorted vision, the appearance of a blind or gray spot in the central vision, and unexplained flashes of light.

Normal Vision

Vision with CSCR

What types of CSCR can occur?

Central Serous Chorioretinopathy can be divided into two different classifications. Traditionally, CSCR is characterized by an isolated leak in the pigmented tissue beneath the retina. However, eye doctors are able to recognize that CSCR may present as a more diffuse disease with multiple leaks and overlying blisters causing widespread visual dysfunction. The disease can be detected and characterized by an office-based diagnostic procedure, flourescein angiography (FA). During FA the broad areas of subretinal tissue which contain these leaks are visible to your Ophthalmologist making this study invaluable in diagnosis and treatment.

Normal Retina

Affected Retina

Who is most at risk?

CSCR has been particularly prevalent among Hispanics and Asians, while it is uncommon in the African-American population. Its prevalence among Caucasians varies. Classically, CSCR has been said to affect men 6-10 times more often than it affects women, being most common in males aged 20-55 years with a type “A” personality. Patients diagnosed at age 50 or later more typically have bilateral disease, demonstrate a decreased male predominance,and often show the more diffuse variety of the disease; it is also common for these patients to have systemic hypertension or a history of corticosteroid use.

What are the recovery rates for CSCR?

The retinal blisters or serous detachments typically resolve by themselves in most patients, with 80-90% returning to 20/25 vision or better. Even after the return of central visual acuity, many recovering CSCR patients still notice loss of contrast, distorted vision, or, rarely, poor night vision. Patients with classic CSCR (characterized by focal leaks) have a 40-50% risk of recurrence in the same eye. A small percentage of patients (5-10%) may fail to recover 20/40 or better visual acuity. These patients will often develop recurrent or chronic serous retinal detachments that can result in progressive retinal pigment atrophy and permanent visual loss to 20/200 or worse.

What kind of treatments are offered for CSCR?

There are different treatments for CSCR depending on the nature and severity of your condition. Dr Sparks will give you a thorough examination to determine which type of therapy is appropriate for you. Tranquilizers or beta-blockers have been used in treating certain detachments, as have propranolol and mifepristone. Injectable drugs such as Avastin have also been used in the treatment of rare complications from CSCR. Classic retinal laser treatment and newer modalities, such as Photodynamic therapy, are also used.